Suicidality

I am not suicidal and I have all the hotlines on speed dial.

But there are guns in the house I live in. They are locked up, and I don’t even know where the safes are. I only have access to a few days’ worth of my meds, and the rest are hidden away until Saturdays when I refill my pill boxes. But other people’s meds are out in the house where I could have access to them. Knives and sharps are not locked up.

All these facts go through my head as I try to convince myself I am in control, and suicide is just a thought.

But it’s not just a thought. It’s also the feeling of wanting death and nothingness and unconsciousness, not just so the pain will stop but also because it seems like the time has come for my life to end. Suicidal feelings are Munch’s “The Scream” – silent, yet horrific, as they tear through the deepest part of you. You are a bottomless pit of dark, dark, dark feelings that spiral down, a corkscrew that drives deeper and deeper into the center of you.

Suicidality includes the impulses to use various items against myself that roll through me like ocean waves, or that jolt me like electricity. The impulses usually include visions of me hurting and killing myself in multiple ways.

I’m ashamed of having these feelings, impulses and thoughts. When I’m not consumed by them. In the moment, they take over and are the only things I experience. Sights, sounds, smells, tastes, touches, thoughts do not exist, only suicidal thoughts, feelings, and impulses. As these become less intense – and they do! – I begin to feel shame and guilt, as though I want these suicidal experiences.

And then, if I am able to feel something else, I start to feel fear, and anxiety ramps up. So, from being overwhelmed by suicide’s thoughts and feelings, I first feel shame, guilt, fear and anxiety. How awful! And from this head- and feeling-space I then question myself: Who am I, that I seem to be consumed by thoughts of death and of killing myself? Who am I, that I come under suicide’s power and don’t even take in other stimuli? And why do I think/feel constantly that my life will end early, most likely at my own hand too?

Suicidality as I experience it is this horrible, horrible, awful experience that pulses through my every day. Some days the experience is less overwhelming and only lasts a few seconds and then passes. Most days the waves of feelings last for several minutes each hour. How can I keep living this way? Why is there no treatment for suicidality?

The Other Shoe Dropped

I hate to say “I told you so,” but I did tell you that stability wouldn’t last. Over the last week-plus, I slipped into depression, with fatigue, hopelessness, sadness, guilt, tearfulness, and the agony of suicidal impulses and visions. What seems different this time is that I am hopeful that it will pass and that I can find stability again. That hope is a HUGE difference! I still fall into utter hopelessness and think life will always feel as horrible as I feel now (and then I often pass into thinking of death as the only way to end such suffering).

I finally told my mom on Sunday how I was feeling, and she insisted I try to get in to see my psychiatrist on Monday. (I had already been texting with my therapist.) He was actually able to squeeze me in! He started me on a med that I tried last year that ended with a hospitalization. He thinks I was already feeling bad and was getting worse anyway, and that the drug didn’t have anything to do with the hospitalization. So, I’ll try again, under my family’s watchful eye, with my doctor on speed dial. He suggested a sun lamp too, first thing in the morning, as well as calling to get in to get some maintenance ECT. (UGH! ECT is NOT what I want to do, though apparently now it works for me…so I guess I should follow my doctor’s advice.) He thought the schedule of an IOP or PHP program might be helpful, but that I didn’t really need to go over coping skills again.

Both my psychiatrist and my therapist agreed that the time of year – the equinox – has something to do with what’s going on for me. As my doctor put it, “Spring is a fragile time,” and “The last 100 patients have had the same problem as you.” He said both spring and fall are the most fragile times (I’m sensitive to the solstices too – Gr-e-e-a-a-t), because it is the circadian rhythms changing. It’s nice to be believed about the time of the year being hard for me! Not everyone at my hospital in Illinois believed me, though the most important people in my life did. So, if any of you are having trouble at this time of year, rest assured that you are NOT alone!

All of this description and action plan just to tell you, dear reader, that I feel Horrible, from the pit deep in my solar plexus and spirit, and Empty and Ugly and Worthless. Leading to hopelessness and deep sadness. Right now, at least, I don’t feel suicidal. I’d like to think I could avoid a hospitalization this time.

The Value Independence

Happy Pi Day! (March 14, 3/14 for 3.14, the decimal approximation of the mathematical concept of pi)

OK, now that I’ve displayed my nerdiness for the day…

I’ve written before about how I have valued living independently very highly among my values. Learning to live with family has been hard, and deciding several times in the past year to continue to do so has been even harder. I’m still learning to live with family, especially sharing my schedule of outside activities. I want a sense of independence. And being able to follow my own whims and schedule is part of what I value about independence. How much independence do I have to give up by living with family?

I am reading a book about the needs and desires of people as they age, Being Mortal by Atul Gawande. At one point today I read these sentences about the two meanings of autonomy: “One [meaning] is autonomy as free action – living completely independently, free of coercion and limitation,” and “Whatever the limits and travails we face, we want to retain the autonomy – the freedom – to be the authors of our lives.”

I believe I have been thinking about living independently in the first sense of autonomy described in the book. I want to live alone, keeping my own household, because I believe that kind of independence shows that I am adult and have learned to live with my limitations. But, as many people have discovered as they age or as part of disability or even as part of enlightenment, we humans live dependently with one another, sometimes with personal and/or household needs taken up by others, sometimes with emotional cares shared with others, sometimes just sharing the rent with another person for financial needs to be met. Over this past year I have come to realize that I am a better human being? or my best self? when I am living with other people. I think I have always been that way, even though I consider myself an introvert who enjoys time in the company of others A Lot. During this year, I realized that I will never be able to live alone anymore, whether with family or with a housemate.

What does not living alone mean for my value “independence”? I still want to follow my own whims and schedules. I’m having a hard time sharing that info or part of myself with others. I still want autonomy, but perhaps I’m thinking about it now in the second sense above: I want to be the author of my life, even as household, financial and emotional needs are met to some degree by housemates. I’m having an epiphany, or becoming enlightened, about the dependent nature of my very human self, which includes living with bipolar and its needs. I no longer feel the need to live alone to show my adultness or ability to manage my limitations. But I do still feel the need to be the author of my life, to make decisions about how I spend my time to enrichen my life. That is what I value about independence.

Living with Bipolar

“Bipolar is just one part of me.” “You are brave and courageous.” “You are feeling good! You can get to this place again.” These are the post-its I see several times a day as I take medication for many things, including bipolar disorder. I’ve been thinking for a few days what it means to live with bipolar disorder, and these three post-its are part of the deal of living with bipolar.

  1. I am many things – compassionate, smart, funny, passionate, nerdy – and bipolar. And though bipolar colors ALL of my existence, it is just one part of me. It is easy for me to say “I am bipolar” instead of the more socially acceptable “I have bipolar.” What my mood and thoughts are doing, and the routines I use to contain them, shapes my whole life. I cannot escape my bipolar brain. When I’m feeling well, like right now I can see how there are parts of me that would be there even if I didn’t have bipolar, like a snarky sense of humor or being passionate about social justice.
  2. I have to be persistent, routinized, and brave Every.Single.Day. Each day I wake up to thoughts that second-guess my mental well-being and my ability to even face a day without causing harm to myself. Courageously I choose to get up and start the routine that will get the day off to a better start. Courageously I take my meds, brush my teeth, drink my coffee and check my calendar. Eventually I can face the day, if it’s a good day. Some days I can only think of suicide and can only feel anxiety and fear. On those days I have still made the choice every minute to keep on living. “Nevertheless, she persisted,” applies not only to U.S. Senators who keep talking despite pressure to shut up and sit down, but also to my choosing life day after day, moment after fearful moment of thoughts of death that won’t stop. I am brave and courageous.
  3. I am living in a euthymic phase right now – a good, stable, middle point of my moods. And I can get there again if/when I become depressed or manic again. I need the reminder both that bipolar is cyclical and that I am in a good phase. It’s time to take a look around! Smell the flowers and trees and other pollens I am violently allergic to. Play with my cat. Sip coffee. Really discover what I am capable of when I am feeling well! It’s time to enjoy this time I have, and trust that it will come again.

What are some insights you have uncovered about living with bipolar, either from your own life, or from watching me live mine?

Mixed Up Feelings

I’m all over the place with my feelings. Not even sure if my mood is shifting too, or just feel down because of so many feelings. I was in a minor car accident this week, with just enough damage to the car to not be driveable. It’s an 18-year-old car, so after a year of constant fixing of things, I decided it’s time to sell or donate for a couple hundred dollars at most, instead of even paying a deductible more for her.

My therapist reminded me that this is a loss, and a sudden one at that. I’ve had the car since its third mile, and for 18 years. I guess it’s natural to get emotional over cleaning out personal items. Not sad, but shaky, like after a rush of adrenaline drains out. I wasn’t sure I’d be able to drive with how shaky I was! But it lessened a bit over the next hour until I had to drive to my therapist.

Now, instead of getting a new-to-me used car, I’m adopting my parents’ car, and all of us will share it. They use it more than they think, but still not very much. So if we coordinate our appointments with a google calendar or something (recommendations accepted!), we should be able to share it. In a year or two, we’ll get a newer car, since this one is pretty old too (17-years-old, but very low mileage).

Deciding to adopt this car into my life was a hard change. It’s connected to the constant debate I have about whether I want to stay in my family’s house or get a housemate and house/apartment of my own. And if I move, do I stay near family, or go back to Chicago, or to California or Oregon, where my roots are? Adopting a family car seems like saying I’m staying in the family house and really making a commitment to live communally with people I have very little in common with. Which if true, begs the question of why keep a storage unit of stuff to populate an apartment.

Do you see my dilemma? I know that no decision is permanent but it feels that way, saying goodbye to my car at all, sharing a car which is hard if not in the same house. My feelings are all over the place! Sad, shaky, out-of-place.

So I presented to my therapist my goal this year of feeling more comfortable with family and with my new stable (I hope) self, and my housing dilemma. He noted that it’s not a specific goal, and I clarified that I’m waiting for a feeling of home and belonging. I still feel like I’m borrowing the guest room, plus the discomfort of being in a car I would Not have chosen.

We narrowed down that I can’t find that feeling until I make the room my own (and the car…) and get more stuff out of storage. With more of my stuff around me, I can see if I can find some of that comfort. And maybe along the way I’ll find more comfort being with these people? That’s part of the belonging too – space AND people. Maybe my feelings will even out a bit in this process too.

Grateful

The last couple days have been thankfully, gratefully, blessed with lower anxiety. So even though I still have suicidal thoughts, they don’t hook into the anxiety and become obsessive. They float in as any thought does, and they float out, blessedly. It’s such a huge relief!

I’ve been busy doing nothing, and exercising occasionally, and moving forward with relearning some college algebra that should help when I start taking those science classes in the fall. I’ve been trying to read, but maybe I need to give up on this book. It’s just not getting anywhere. Or I can’t focus for very long, which is a feature I run into regularly. Maybe I’ll try another book for a while.

My mood is a little low, but still in the balanced arena, I think. As happens when I’m depressed, I’m fatigued for hours after I wake up, despite jolts from coffee. And I cancelled on some times to get together with people, another sign of depression for me. I’m not convinced either way that I’m depressed or not depressed. Time will tell?

Not Just Grieving or Angry

I still have near constant suicidal thoughts as discussed in my last post. I’ve researched some possibilities to carry it out, and come to the same conclusion that my primary method is the best for me, AND I cannot do it because several methods are hidden from me by my family.

So there. I’m safe. Just miserable and wanting to end the misery. And the best way to end the misery seems to be to follow the thoughts’ plan.

My thoughts seem to say “I’m not fleeting. I’m persistent. Do it. Here’s a scenario.” Sometimes this repeats ad nauseum. Sometimes I can look with the self and notice that they are thoughts, and see that they are not coming from the Self. But even when I can create distance in this way, I do not know from whence the thoughts cometh. Arguably, from bipolar. The diseased part of the brain. Yet that is part of me. I can’t yet see bipolar as Other-Than-Me, when it comes from MY brain. How can I even distinguish diseased-brain from me-brain? My cognitive abilities are so hampered, even when my mood is in the middle, neither depressed nor manic. So much of ME is taken up by diseased-brain with all the cognitive jumble and lack of function I live with. It’s amazing I can even drive.

My thoughts also seem to say, “I hate this limping life. This is not the life we signed up for. I expected some good things, such as lasting relationships, an interesting career, and a developing/ed intellectual self. What is this hobbling along day-by-day, hour-by-shuffling-hour business?”

I’m grieving – Still! – the life I had and thought would continue. But it’s more than grief. I’m angry at being robbed of this life, but it’s more than anger. I’ve sat with these emotions and phases Multiple Times. Sometimes, like a few posts ago when I was signing up for college classes, I seem to have accepted, or at least embraced this limping, hobbling life bipolar has left for me, and made some good fortune happen.

When all is said and done, and I’m alone with my bipolar and suicidal thoughts, I Have Not Accepted that this is my life. I think that’s one reason why I want to end it. What else do you see in this mess? Help me.